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Tahani B, Baghban AA, Kazemian A. Determinants of oral health status: an ecological study in Iran. BMC Oral Health 2023; 23:910. [PMID: 37993816 PMCID: PMC10666374 DOI: 10.1186/s12903-023-03557-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/19/2023] [Indexed: 11/24/2023] Open
Abstract
OBJECTIVES The aim of this ecological study was to assess the association between behavioral, social position, circumstance factors, and caries experience in 35- to 44-year-old adults in Iran at a provincial level. MATERIALS AND METHODS The data from the 2011 Iranian Oral Health Survey were obtained from all 31 provinces across Iran on the population level. Oral health status was measured as the number of decayed, missing (MT), and filled (FT) teeth and the percentage of the population who were edentulous. Data were also gathered from each province on the percentage of smokers (Non-Communicable Diseases Risk Factors Surveillance Provincial Report 2009), per capita consumption of free sugars, concentration of fluoride in the drinking water (National and Sub-national Burden of Disease (NASBOD) Survey), number of dentists per 10,000 people, mean years of schooling of adults, expected years of schooling of children, life expectancy at birth and Gross National Income (Integrated Public Use Microdata Series, Global Data Lab). The data were analyzed using simple and multiple linear regression (α = 0.05). RESULTS Mean DMFT was positively associated with the percentage of smokers (B = 0.01 95%CI 0.01-0.14), and negatively with fluoride concentration (B =-2.6 95%CI -4.3- -0.96). The edentulousness percentage was positively associated with smoking (B = 0.2 (with 95%CI: 0.07-0.37) and negatively with mean years of education (B =-1.08 (with 95%CI: -2.04- -0.12). DT was associated with expected years of schooling (B =-0.6 (with 95%CI: -1.07- -0.17), negatively. Mt was negatively associated with life expectancy (B =-0.5 (with 95%CI: -1.1- -0.007), fluoride concentration (B =-3.4 (with 95%CI: -4.5- -1.5) and number of dentists per 10,000 people (B =-0.4 (with 95%CI: -0.8- -0.01). Mean Years of Schooling (B = 0.5 (with 95%CI: 0.2-0.8) and number of dentists per 10,000 people (B =-0.62 (with 95%CI: 0.51 - 0.48) were positively in associated with FT. CONCLUSIONS The present findings indicate that there were differences in the oral health measures and their social determinants among the provinces of Iran. Regarding the limitations of the study especially the limitation of the number of independent variables, it seems, this discrepancy could be better explained by social variables of the provinces such as income than by environmental factors.
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Affiliation(s)
- Bahareh Tahani
- Department of Oral Public Health, Dental Research Center, Dental Research Institute, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Kazemian
- Department of Community Oral Health, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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Kaewkamnerdpong I, Harirugsakul P, Prasertsom P, Vejvithee W, Niyomsilp K, Gururatana O. Oral status is associated with chewing difficulty in Thai older adults: data from a National Oral Health Survey. BMC Oral Health 2023; 23:35. [PMID: 36683036 PMCID: PMC9867856 DOI: 10.1186/s12903-023-02742-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/13/2023] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The number of older adults in Thailand is increasing. Better chewing ability is associated with healthy aging. Although numerous studies have demonstrated the relationship between social backgrounds, dental service utilization, oral status and chewing difficulty, there is no study in Thailand using national oral health data to identify the variables involved with chewing difficulty among Thai older adults. Therefore, the aim of this study was to determine the association between oral status, and chewing difficulty, adjusting for social backgrounds, and dental service utilization among Thai older adults. METHODS This cross-sectional study used data from the eighth Thai National Oral Health Survey (TNOHS). A stratified multi-stage method was used for sample selection. The eighth TNOHS was conducted from June-August 2017. Data were collected using interviews and clinical oral examinations by trained interviewers and trained dentists, respectively. The bivariate analysis, chi-square test was used to explore the associations between social backgrounds, dental service utilization, oral status, and chewing difficulty. Dependent variables with p-values of < 0.2 for their association with independent variables in the bivariate analysis were entered into the multiple logistic regression models. RESULTS This study found that older adults with at least 27 teeth (p < 0.05), or at least eight occlusal pairs (p < 0.05) or income exceeding 15,000 baht per month (p < 0.05) were more likely to have less chewing difficulty (p < 0.001), while the elderly who utilized dental services in the past 12 months were associated with more chewing difficulty than those who did not utilize dental services in the past 12 months (p < 0.001). CONCLUSIONS We suggest that policymakers increase the number of preventive plans and set a goal for more than 20 remaining natural teeth and four posterior occlusal pairs in young and working aged people, especially in the low income group.
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Affiliation(s)
| | - Punkanit Harirugsakul
- Department of Oral Diagnosis and Oral Surgery, Faculty of Dentistry, Western University, Pathumthani, Thailand
| | - Piyada Prasertsom
- Department of Health, Bureau of Dental Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Warangkana Vejvithee
- Department of Health, Bureau of Dental Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Kornkamol Niyomsilp
- Department of Health, Bureau of Dental Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Orachad Gururatana
- Sirindhorn College of Public Health Chonburi, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Ministry of Public Health, 29 Wachiraprakarn Road, Chonburi Province, Postcode, 20000, Thailand.
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Quality of education and adolescents’ oral health-related behaviours: a multilevel analysis. Eur Arch Paediatr Dent 2022; 23:547-556. [DOI: 10.1007/s40368-022-00700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
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Najafi F, Rezaei S, Hajizadeh M, Soofi M, Salimi Y, Kazemi Karyani A, Soltani S, Ahmadi S, Homaie Rad E, Karami Matin B, Pasdar Y, Hamzeh B, Nazar MM, Mohammadi A, Poustchi H, Motamed-Gorji N, Moslem A, Khaleghi AA, Fatthi MR, Aghazadeh-Attari J, Ahmadi A, Pourfarzi F, Somi MH, Sohrab M, Ansari-Moghadam A, Edjtehadi F, Esmaeili A, Joukar F, Lotfi MH, Aghamolaei T, Eslami S, Tabatabaee SHR, Saki N, Haghdost AA. Decomposing socioeconomic inequality in dental caries in Iran: cross-sectional results from the PERSIAN cohort study. ACTA ACUST UNITED AC 2020; 78:75. [PMID: 32832079 PMCID: PMC7436972 DOI: 10.1186/s13690-020-00457-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/10/2020] [Indexed: 12/24/2022]
Abstract
Background The current study aimed to measure and decompose socioeconomic-related inequalities in DMFT (decayed, missing, and filled teeth) index among adults in Iran. Methods The study data were extracted from the adult component of Prospective Epidemiological Research Studies in IrAN (PERSIAN) from 17 centers in 14 different provinces of Iran. DMFT score was used as a measure of dental caries among adults in Iran. The concentration curve and relative concentration index (RC) was used to quantify and decompose socioeconomic-related inequalities in DMFT. Results A total of 128,813 adults aged 35 and older were included in the study. The mean (Standard Deviation [SD]) score of D, M, F and DMFT of the adults was 3.3 (4.6), 12.6 (10.5), 2.1 (3.4) and 18.0 (9.5), respectively. The findings suggested that DMFT was mainly concentrated among the socioeconomically disadvantaged adults (RC = - 0.064; 95% confidence interval [CI), - 0.066 to - 0.063). Socioeconomic status, being male, older age and being a widow or divorced were identified as the main factors contributing to the concentration of DMFT among the worse-off adults. Conclusions It is recommended to focus on the dental caries status of socioeconomically disadvantaged groups in order to reduce socioeconomic-related inequality in oral health among Iranian adults. Reducing socioeconomic-related inequalities in dental caries should be accompanied by appropriate health promotion policies that focus actions on the fundamental socioeconomic causes of dental disease.
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Affiliation(s)
- Farid Najafi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Moslem Soofi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Kazemi Karyani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahin Soltani
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sina Ahmadi
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Enayatollah Homaie Rad
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradi Nazar
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Mohammadi
- Department of Health Information Technology, Paramedical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazgol Motamed-Gorji
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Moslem
- Department of Anesthesiology, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ali Asghar Khaleghi
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mohammad Reza Fatthi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Aghazadeh-Attari
- Social determinants of Health Research Center, Urmia Jundishapur University of Medical Sciences, Urmia, Iran
| | - Ali Ahmadi
- Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Farhad Pourfarzi
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrnoush Sohrab
- Diabetes Research cente, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Ansari-Moghadam
- Health Promotion Research Center, Zahedan Jundishapur University of Medical Sciences, Zahedan, Iran
| | - Farhad Edjtehadi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Esmaeili
- Department of Cardiology, Medical school, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Teamur Aghamolaei
- Department of Public Health, School of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Saied Eslami
- Pharmaceutical Research Center, Pharmaceutical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Nader Saki
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Akbar Haghdost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Ghasemi E, Akbarzadeh Baghban A, Zayeri F, Pourhoseingholi A, Safavi SM. A doubly-inflated Poisson regression for correlated count data. J Appl Stat 2020; 48:1111-1127. [DOI: 10.1080/02664763.2020.1757049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Erfan Ghasemi
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farid Zayeri
- Proteomics Research Center and Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asma Pourhoseingholi
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammadreza Safavi
- Research Institute of Dental Sciences, Dental Research Center, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kang J, Smith S, Pavitt S, Wu J. Association between central obesity and tooth loss in the non‐obese people: Results from the continuous National Health and Nutrition Examination Survey (
NHANES
) 1999–2012. J Clin Periodontol 2019; 46:430-437. [DOI: 10.1111/jcpe.13091] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 02/14/2019] [Accepted: 02/16/2019] [Indexed: 01/09/2023]
Affiliation(s)
- Jing Kang
- Division of Oral BiologySchool of DentistryUniversity of Leeds Leeds UK
| | - Scott Smith
- Division of Applied Health and Clinical TranslationSchool of DentistryUniversity of Leeds Leeds UK
| | - Susan Pavitt
- Division of Applied Health and Clinical TranslationSchool of DentistryUniversity of Leeds Leeds UK
| | - Jianhua Wu
- Division of Applied Health and Clinical TranslationSchool of DentistryUniversity of Leeds Leeds UK
- Leeds Institute for Data AnalyticsUniversity of Leeds Leeds UK
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Wang L, Cheng L, Yuan B, Hong X, Hu T. Association between socio-economic status and dental caries in elderly people in Sichuan Province, China: a cross-sectional study. BMJ Open 2017; 7:e016557. [PMID: 28947446 PMCID: PMC5623543 DOI: 10.1136/bmjopen-2017-016557] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/14/2017] [Accepted: 08/22/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES As a vulnerable group, the elders' oral health gained less attention, particularly the relationship between socioeconomic status (SES) and dental caries. This study aimed to assess the associations and to explore the effects of confounders on the associations in elderly people. DESIGN Cross-sectional study. SETTINGS 3 neighbourhood committees and 3 village committees in Sichuan Province, China. PARTICIPANTS 744 people (362 men and 382 women) aged 65-74 years were included. OUTCOME MEASURES Oral health outcomes included the decayed, missing and filled teeth (DMFT) index and its components. SES was assigned by educational level, household income and type of household. The bivariate association between the participants' characteristics and DMFT was analysed using non-parametric tests. Four logistic regression models were used to analyse the associations between SES and dental caries by regulating confounders. RESULTS Poor oral health was observed in these participants. Bivariate analysis showed a significant association between SES and DMFT (p﹤0.05). Only adjusting gender, high educational level (adjusted (AOR)=0.34, 95% CI 0.17 to 0.66), high household income (AOR=0.47, 95% CI 0.41 to 0.77) were protective factors against dental caries, and living in agricultural families (AOR=1.86, 95% CI 1.32 to 2.63) was risk factor (p﹤0.05). After adjusting other confounders, SES was partly related to the dental caries. Moreover, an interaction existed among SES indicators. CONCLUSIONS SES is associated with dental caries, and older people with low SES have poor oral health. The associations were explained partly by diet, behaviour and awareness. Our results provide effective evidence in targeted policy-making and intervention measures and implicate that pertinence measures, economic assistance and medical insurance funds should be provided to older people of low SES. Furthermore, a follow-up design should attempt to confirm the causal relationship between SES and dental caries and evaluate the effect of intervention.
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Affiliation(s)
- Linyan Wang
- Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Li Cheng
- Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Bo Yuan
- Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xiao Hong
- Department of General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Tao Hu
- Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Islas-Granillo H, Borges-Yáñez A, Fernández-Barrera MÁ, Ávila-Burgos L, Patiño-Marín N, Márquez-Corona MDL, Mendoza-Rodríguez M, Medina-Solís CE. Relationship of hyposalivation and xerostomia in Mexican elderly with socioeconomic, sociodemographic and dental factors. Sci Rep 2017; 7:40686. [PMID: 28094800 PMCID: PMC5240562 DOI: 10.1038/srep40686] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 11/29/2016] [Indexed: 11/09/2022] Open
Abstract
We determined the prevalence of hyposalivation and xerostomia in older Mexicans (≥60 years), and its relationship with diverse factors. A cross-sectional study was realized in elderly subjects from Pachuca, Mexico. Chewing-stimulated saliva was collected under standardized conditions and salivary flow was measured; subjects were considered to have hyposalivation if their stimulated salivary flow was less than 0.7 mL per minute. Xerostomia was evaluated by asking subjects 'Does your mouth feel dry?'. Hyposalivation was present in 59.7%, and xerostomia in 25.2% of subjects. 16.5% of subjects had both conditions. Xerostomia was present in 27.7% of subjects with hyposalivation and 21.4% of subjects without hyposalivation, but the difference was not significant (p > 0.05). Thus, 68.3% of older Mexicans had xerostomia and/or hyposalivation. Factors associated with hyposalivation were: using fewer devices in oral hygiene, lacking social benefits for retirement/pension, living in a public retirement home, brushing teeth less than twice a day and lacking teeth without dentures. None of the factors included in this study were associated with xerostomia. We concluded that several variables studied were associated with hyposalivation, but none for xerostomia. Additional research should examine the amount of hyposalivation and factors associated with hyposalivation especially in elderly with increased risk for hyposalivation.
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Affiliation(s)
- Horacio Islas-Granillo
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico
| | - Aida Borges-Yáñez
- DEPeI Faculty of Dentistry of National Autonomous University of Mexico, Ciudad de Mexico, Mexico
| | | | - Leticia Ávila-Burgos
- Health Systems Research Centre at National Institute of Public Health, Cuernavaca, Mexico
| | - Nuria Patiño-Marín
- Clinical Research Laboratory of Dental Sciences Doctorate Program at Autonomous University of San Luis Potosí, San Luis Potosí, Mexico
| | | | - Martha Mendoza-Rodríguez
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico
| | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico.,Advanced Studies and Research Center in Dentistry "Dr. Keisaburo Miyata" of School of Dentistry at Autonomous University State of Mexico, Toluca, México
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